Inspection on 14/10/05 for Grangewood

This inspection was carried out on 14th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grangewood 07/11/06

Grangewood 01/02/06

Grangewood 05/10/04

Grangewood 08/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Beau Sejour

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Grangewood 10/12 High Street Kelvedon Colchester Essex CO5 9AG Lead Inspector Andrea Carter Unannounced Inspection 14th October 2005 09:30 Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grangewood Address 10/12 High Street Kelvedon Colchester Essex CO5 9AG 01376 570208 01376 571739 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) SCOPE Mrs Marie Jones Care Home 19 Category(ies) of Learning disability (19), Learning disability over registration, with number 65 years of age (2), Physical disability (19), of places Physical disability over 65 years of age (2) Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two persons, aged 65 years and over, who require care by reason of a learning disability who may also have a physical disability, whose names were made known to the Commission in March 2003 Persons of either sex, under the age of 65 years, who require care by reason of a learning disability who may also have a physical disability (not to exceed 19 persons) 5th October 2004 2. Date of last inspection Brief Description of the Service: Grangewood provides a residential service for younger adults and older people with disabilities associated with cerebral palsy. The home was originally registered as two buildings with the original seventeenth century house having two floors accommodating some service users with offices on the first floor. However, since the intended redevelopment of the site the service users are no longer accommodated in the older premises, as all now live within the purpose built one storey building adjacent to the older house. The premises had adequate wheelchair access. The single storey accommodation provides single bedrooms, one with en-suite, and is split into two small units providing sitting and dining room spaces. The service users also benefit from a ground floor activity area. Car parking facilities are available and there is a large enclosed, well-maintained garden. The old building, “The Grange”, now provides a staff sleep-in room, guest flat, family room, staff and a service users training room. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 14th October between the hours of 9:30am and 4:30pm which involved a site visit. The inspection commenced with the Manager giving a guided tour of the premises and an introduction to staff and service users. Sixteen standards were assessed with fifteen being met and one with minor shortfalls Field work included direct observation of working practices, discussion with service users and staff and management. Formal documentation supported the evidence and decisions that formulate this inspection report. Three service user comment cards were received back and all indicated they were happy with the services they receive although did indicate they did not always enjoy residing in the home. Two relative cards outlined they were content with the service and had never had to place a complaint. A health Care professional who commented supported this. However, the inspection was not considered concluded until the 28 October as receipt of information to review was received. What the service does well: Personalisation of bedrooms, to reflect individual choice of furnishings and items of preference. Respecting the individuality of service users in their dress sense and choice of personal hobbies and pastimes. The service provides a nutritional and wide variety of daily meals. The service provides facilities to enable friends, and relatives to stay within the site. The home enables service users to maintain regular family contact, and provides transport to facilitate this. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 Service user generally have the information they need to make an informed choice about where to live. EVIDENCE: The service has now developed a service users guide, which sets out the information for service users in a clear concise and accessible format. The guide requires expansion of information around the key contract terms covering admission occupancy and termination of contract. The process for the complaints procedure should also be included. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 69 Service users know their assessed and changing needs and personal goals are reflected in their individual plan. Service users are supported to take risks as part of an independent lifestyle. EVIDENCE: Three service users files were case tracked, of which one individual was a new admission. The files contained in depth information in the form of an individualised care plan for each person. The plans were formulated from pre assessment and admission information. The content was a clear reflection of the personal level of care and needs of the person. A sheet entitled “getting to know the individual” was positive evidence of the proactive way information is relayed to staff prior to admission. All files contained personal care information, communication needs, daily records risk assessments and areas of vulnerability. Each service user has an identified key worker that has responsibility in relation to reviewing the current care plan with the individual and this was Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 10 confirmed in conversation with one staff member. Reviews take place on a monthly basis. The plans were comprehensive and clearly indicated the level of understanding of the specialist needs of the service user group All files had individualised risk assessment of daily living ranging from bathing, manual handling, to wheelchair use. One individual who was agoraphobic, with a support management plan now can access the community on occasions, supported by his key worker. Individuals are supported in a wide variety of activities, all of which are risk assessed on an individual basis. Risk assessments also reflected such areas as exercise, presentation of aggression, health issues and holidays. Generic risk assessments are in place and form a comprehensive over view of areas deemed to be a risk to service users ,staff or others. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 15 17 Service users engage in appropriate leisure activities Service users have the opportunity to develop and maintain personal and family relationships. Service users are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: A range of leisure pursuits are offered or assessed, both within the residential home and the wider community. Access to a daycentre is timetabled weekly for various individuals, whose choice it is to participate in offered pursuits. These include art and crafts, massage and aromatherapy. Currently the service is fundraising for multi sensory equipment, to then set up a resource within the unit. The manager and senior member of staff have drawn up new care profiles that have been submitted to the local authority, along with relevant fee increases, to incorporate a five-day holiday for service users. Fourteen of the fifteen service users have been reviewed and to date five authorities are in agreement with the fee increase, which will incorporate the holiday for individuals. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 12 Service users are encouraged fully to maintain family and friendship links. There is the opportunity for families and friends to stay over in the Grange, a separate unit on the site. This can be accessed whilst visiting family members and provides a private resource for families. Individuals participate in home visits on a three weekly or monthly basis; supported by key workers. Transport can be provided by the service if necessary. Telephone calls and letters are enabled and encouraged and service users are able to access family contact via email. Observation of the lunchtime meal indicated a relaxed environment. The meals being eaten were well presented. The weekly menu clearly represented a wide variety of food was being offered. Nutritional sheets sampled indicated a choice for individuals, with alternatives on offer. There are two cooks currently employed, who obtain service users preference through discussion and in turn reflect this within the weekly menu. Meal times are flexible, for individual’s attendance. Individual risk assessments outline any eating and drinking difficulties for service users, with support being given on a one to one basis as required. Discussion with the cooks confirmed that all produce was brought fresh from local supermarkets. Documentation confirmed appropriate temperature checks now take place daily, as and when required. This was a requirement from the previous inspection. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Service users receive personal support and in the way they prefer and require. Service users physical and health needs are met. Service users are protected by the homes policies and procedures for dealing with medication. EVIDENCE: One staff member spoken to outlined he had been key worker for a period of eight years; it was the service users individual choice to have this staff member support and work alongside him. The individuals care plan supported the staff member’s discussion around privacy, dignity and individual choice. Observation of routines and working practices supported the flexibility of timetable’s and support given. Specialist support had been given through the occupational therapist, in relation to wheelchair use and routines to assist with bathing. The key worker was fully aware of the service users needs Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 14 Service users are registered with the local General practitioner. Visits are made to the surgery or within the home dependant on the needs of the individual; within in the privacy of their own room. Healthcare provision is also accessed in the form of opticians, dentists and a chiropodist who attends on site. Training is in place to enable staff to be fully au fait with the health and support needs of individuals. Current practice for staff incorporates a learning session around medication, involving staff compiling an overview of current medication administered, drug name, side effect and use of medication. This supports and enhances current staff knowledge in this area, and is evidence of innovative practice implemented by the manager. The medication files sampled contained consent forms signed by individual service users. A clear audit trail is documented in respect of medication received and administered. The services medication policy was appropriate. All staff have been on a medication or refresher course as required; with only one member of the current team remaining to participate and complete this training. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected EVIDENCE: Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25 26 28 30 Service users bedrooms suit their needs and lifestyles. Service users bedrooms promote their independence. Service users bathrooms provide sufficient privacy and meet their individual needs, but some areas need refurbishment. The home is clean and hygienic. EVIDENCE: There are nineteen single occupancy bedrooms within Grangewood; all of which meet with the requirements of useable floor space per individual All bedrooms are accessible and have adequate space and facilities to accommodate wheelchair users. Bedrooms accessed clearly represented a reflection of the individuals personal choice, in relation to colour, personal furnishings and preference of items contained within. All bedrooms had appropriate furnishings and washing facilities. Electric overhead hoists supported the individual needs of service users. The bedding and curtains were of a good quality. This in turn created a homely and personal feel to each room. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 17 One of the bathrooms had recently had a Jacuzzi bath fitted. The flooring within this bathroom was split and worn It did not form a seal of the flooring and required immediate attention. The second bathroom was currently under refurbishment and was a project lead by the art group in the choice of colours and the theme of murals being painted to the walls. Once complete a second Jacuzzi bath will be fitted to this bathroom. The third bathroom, albeit containing the oldest bath, appeared to be the service users favourite as it was deep and enabled a full body “soak” within the bath. The home presented as clean and free from odours. The laundry room despite its age and condition is housed separately to the main residential block and is functional for the purpose of which it is intended. The service has recently purchased a new commercial washing machine with the facilities to meet the specified standards for disinfection. There is a robust infection control policy in place, with appropriate procedures for all specified areas. The checklist, that forms part of the induction for newly appointed staff, is comprehensive around this area. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Service users individual and joint needs are met by appropriately trained staff. EVIDENCE: The service has a training and development plan in place, incorporating the areas of training scheduled for each staff member, over a twelve month period. Staff files sampled supported attendance of identified courses. Scope has now produced a workbook incorporating induction and foundation for new staff. This is due to be implemented within the next three months. There is also a national induction to Scope, which is facilitated by the Human Resources Department of the service for all newly recruited staff. The service has a budget identified for the current year, which is considered adequate for its training needs. Specialist training is researched and obtained when the needs of service users change. The service is investigating conflict management and challenging behaviour at the current time. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Service users benefit from a well run home. Service users are confident their views underpin all self monitoring, review and development by the home The health, safety and welfare of service users are promoted and protected. EVIDENCE: The current manager completed and passed the NVQ level four registered managers award in august 2005. The manager’s job description; clearly identifies the level of responsibility attributed to this post. There is evidence that along side the NVQ qualification recently obtained; the manager continues to update her knowledge base with a variety of other training course attended. The service had recently developed its own in-house quality assurance system. The documentation sampled, included questionnaire sheets that had been Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 20 distributed to both stakeholders and service users. The service is currently waiting for the return of responses in respect of this. The formulation of a working party, consisting of a cross section of individuals to include, management, service users, stakeholders and staff; has enabled the aims, objectives and standards to be identified for Grangewood for 2005/2006. This is a comprehensive document proactively recognising the areas of development and progression for the service over the forthcoming twelve months. The service has appropriate policies and procedures in place around moving and handling. Individualised risk assessments were contained within care plans. Generic risk assessments, in respect of the environment, were also in place. The service ensured that regular checks and servicing of all fire equipment took place. This is in house, with the responsibility taken on by senior staff, as well as via an identified service provider for this area. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 3 2 x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 3 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Grangewood Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x DS0000017835.V260265.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? All areas from the previous inspection were met. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 17(2) 16 Requirement The Registered manager must ensure that the missing persons procedure includes up to date information in relation to the Commission for Social Care Inspection. The Registered manager must ensure that the premises are kept in a good state of repair internally.This relates specifically to the bathroom flooring. Timescale for action 31/12/05 2 YA27 23(2)(b) 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA6 YA6 Good Practice Recommendations Individuals choice around non attendance of activities should be documented to the care plan Incident sheets should be completed with more comprehensive information and detail. Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Grangewood DS0000017835.V260265.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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